乳腺癌患者肺部真菌感染的治疗及临床分析

Risk factors of pulmonary fungal infections in breast cancer patients and the clinical treatment

目的分析医院乳腺癌合并肺部真菌感染的相关影响因素,为临床诊断治疗提供决策依据。方法回顾性分析医院2009年1月-2011年12月184例住院治疗乳腺癌患者的临床资料,统计分析乳腺癌肺部真菌感染的危险因素及临床治疗效果。结果 184例乳腺癌患者中共有26例发生肺部真菌感染,感染率为14.1%;致病真菌以白色假丝酵母菌为主,占65.4%;单因素检验显示,肿瘤分期、白细胞计数、抗菌药物应用时间是影响乳腺癌患者肺部真菌感染的高危因素(P<0.05);伊曲康唑治疗乳腺癌肺部真菌感染患者显效8例,有效12例,无效6例,有效率为76.9%。结论肿瘤分期差、白细胞计数低、抗菌药物应用时间长是乳腺癌患者肺部真菌感染的高危因素,伊曲康唑是治疗乳腺癌肺部真菌感染的有效方法。

OBJECTIVE To investigate the risk factors of pulmonary fungal infections in breast cancer patients so as to provide reliable basis for the clinical diagnosis and treatment. METHODS The clinical data of 184 cases of breast cancer patients who were treated in the hospital from Jan 2009 to Dec 2011 were retrospectively analyzed, the risk factors of the pulmonary fungal infections in the breast cancer patients were statistically analyzed, and the efficacy of the clinical treatment was observed. RESULTS Of 184 cases of breast cancer patients, the pulmonary fugal infections occurred in 26 cases with the infection rate of 14.1 %. Candida albicans was the predominant species of the pathogens,accounting for 65.4%. The univariate analysis showed that the pulmonary fungal infections were closely related to the tumor stage, white blood cell count, time of use of antibiotics （P〈0. 05）. After the treatment with itraconazole, there were 8 cases markedly effective, 12 cases effective, and 6 cases invalid,with the effective rate of 76.9%. CONCLUSION The poor tumor stage, low count of white blood cell, and long-term use of antibiotics are the high-risk factors for the pulmonary fungal infections in the breast cancer patients, and itraconazole is an effective drug for the treatment of pulmonary fungal infections in the breast cancer patients.